OF [email protected] CLIENT SERVICE CENTRE 130 QUEEN STREET WEST PHONE: 416-947-3315 OR 1-800-668-7380 EXT. 3315 , ON M5H 2N6

LAW SOCIETY OF ONTARIO INFORMATION FOR A RULE 7.6-1.1/SUBRULE 6.01(6) APPLICATION FROM A FORMER OR SUSPENDED LICENSEE OR A LICENSEE WHO HAS GIVEN AN UNDERTAKING NOT TO PRACTISE LAW OR PROVIDE LEGAL SERVICES

FOR THE PURPOSES OF AN APPLICATION UNDER RULE 7.6-1.1 OF THE RULES OF PROFESSIONAL CONDUCT OR SUBRULE 6.01(6) OF THE PARALEGAL RULES OF CONDUCT, THIS FORM MUST BE COMPLETED BY:

Any person who, in Ontario or elsewhere, has been disbarred and struck off the Rolls, has had their licence to practise law or to provide legal services revoked, has been suspended, has had their licence to practise law or to provide legal services suspended, has undertaken not to practise law or to provide legal services, or who has been involved in disciplinary action and been permitted to resign or to surrender their licence to practise law or to provide legal services, and has not had their licence restored.

Instructions: Complete all sections. Provide additional information on a separate sheet if required.

PART A – APPLICANT’S INFORMATION

1. PERSONAL INFORMATION Applicant’s Full Name:

Name of Law Society: Law Society Number:

2. BUSINESS CONTACT INFORMATION Business/Employer Name and Address:

Position or Title:

Telephone/Mobile:

Fax:

Email:

3. HOME CONTACT INFORMATION Home Address including Postal Code:

Telephone/Mobile:

Email:

NOTE: By-Law 8 requires licensees to notify the Law Society immediately after any change in the above contact information. Page 1 PART B – WORK HISTORY

Set out in full chronological order your work history and employment both before and since you became a former or suspended licensee or a licensee who has given an undertaking not to practise law or provide legal services.

Date From: Date To:

Nature of Work/Practice:

Business/Employer Name and Address:

Reason for leaving:

Date From: Date To:

Nature of Work/Practice:

Business/Employer Name and Address:

Reason for leaving:

Date From: Date To: Nature of Work/Practice:

Business/Employer Name and Address:

Reason for leaving:

Page 2 PART C – FORMER LICENSEE

Complete Part C only if you are a former licensee.

NOTE: Go directly to Part D if your licence is suspended or you have given an undertaking not to practise law or provide legal services.

Answer all of the following questions. If you answer YES to any question below, provide an explanation at the bottom of page 4.

A. Have you ever been found guilty of, or convicted of, any offence under any statute? Exclude speeding and parking tickets.

YES NO

B. Are you currently the subject of criminal proceedings?

YES NO

C. Has judgment ever been entered against you in an action involving fraud?

YES NO

D. Are there any outstanding civil judgments against you? If YES, attach a copy of the judgments.

YES NO

E. Have you ever disobeyed any order of any court requiring you to do any act or to abstain from doing any act?

YES NO

F. Have you ever been discharged from any employment where the employer alleged there was cause?

YES NO

G. Have you ever been suspended, disqualified, censured or otherwise disciplined as a member of any professional organization? If YES, attach a letter or certificate of standing.

YES NO

H. Have you ever been denied a licence or permit, or had any licence or permit revoked for failure to meet good character requirements?

YES NO

I. Have you ever been refused admission as a student-at-law, articled clerk or similar position in any professional body?

YES NO

Page 3 J. While attending a post-secondary institution, have allegations of misconduct ever been made against you, or, have you ever been suspended, expelled or penalized by a post-secondary institution for misconduct? If YES, attach written details of the allegation and suspension, expulsion and penalty imposed on you.

YES NO

K. Are you currently subject to a petition or assignment in bankruptcy or a proposal to creditors under the Bankruptcy and Insolvency Act, or have you ever been bankrupt or insolvent, under any statute? If you have been discharged, attach proof of the discharge. (Information on obtaining a discharge can be found on the web site of the Office of the Superintendent of Bankruptcy of : https://www.ic.gc.ca/eic/site/bsf-osb.nsf/ eng/home ) YES NO L. Have you ever been disciplined by an employer, or been a respondent in proceedings, in relation to a Human Rights Code violation (e.g., sexual harassment, racial discrimination)?

YES NO

M. Have you ever been sued for damages in a civil law suit, whether in your professional or personal capacity, that alleged civil fraud, breach of fiduciary duty, breach of trust, or any other cause of action that may have related to you acting in your capacity as a solicitor, executor, trustee, director, mortgage broker or fiduciary?

YES NO

N. Has any licensee of the Law Society ever employed you, used your services, or occupied office space with you since your licence was revoked or you were permitted to surrender your licence, or, has any licensee ever applied under rule 7.6-1.1/subrule 6.01(6) to employ you, use your services, or occupy office space with you?

YES NO

If you answered YES to any of the above questions, provide relevant information to be considered in support of your application:

Page 4 PART D – SUSPENDED OR GIVEN AN UNDERTAKING NOT TO PRACTISE

Complete Part D only if your licence is suspended or you have given an undertaking not to practise law or provide legal services.

A. Are you now or have you ever been suspended, disqualified, censured, the subject of a conduct, capacity or competence proceeding or otherwise the subject of discipline in any jurisdiction(s) where you are or were licensed to provide legal services or practise law?

YES NO

B. Have you been the subject of any insurance claims during the three years immediately preceding the date on this application?

YES NO

C. Are you aware of any complaint or charge pending against you in your professional capacity, which has not yet come to the attention of your Law Society or professional/regulatory/governing body?

YES NO

D. Are you now or have you ever been the subject of an insurance claim alleging fraud or dishonesty under a policy for professional liability insurance?

YES NO

E. Are there any outstanding civil judgments against you?

YES NO

F. Has any licensee of the Law Society ever employed you, used your services, or occupied office space with you since your licence was suspended, or you gave an undertaking not to practise law or provide legal services, or, has any licensee ever applied under rule 7.6-1.1/subrule 6.01(6) to employ you, use your services, or occupy office space with you?

YES NO

If you answered YES to any of the above questions, provide relevant information to be considered in support of your application.

Page 5 PART E – RELATIONSHIP WITH APPLICANT LICENSEE

Name of applicant licensee applying under rule 7.6-1.1/subrule 6.01(6):

Provide information below about your knowledge of, and relationship with, the applicant licensee:

Page 6 PART F – OTHER INFORMATION

Provide other information you consider relevant to the application that would assist in determining whether approval should be granted:

Page 7 PART G – AUTHORIZATION AND DECLARATION

I acknowledge that in the course of considering the rule 7.6-1.1/subrule 6.01(6) application, the Law Society will review any and all information in its possession. I acknowledge that the Law Society will be releasing information in its possession to the applicant licensee, in order to confirm their knowledge of my history and information provided in connection with this application. I acknowledge that I may be requested by the Law Society to provide releases or directions, for the purpose of assisting the Law Society in confirming and determining information from other sources.

I hereby authorize the Law Society of Ontario to make inquiries of any person or government, any official or body, including, without limitation, any police or academic authority, about my background or character. I will provide any additional specific authorization or any release that is required for the purpose of enabling the Law Society of Ontario to obtain information related to my background or character.

I understand that I have a continuing obligation to immediately provide written notification of any change to the information that I have provided to the Law Society of Ontario in connection with this application.

I solemnly declare that all information provided by me with respect to this application, and in the documents provided in connection with this application, is true, accurate, and complete.

Date:

Signature of Former or Suspended Licensee or Licensee who has Given an Undertaking not to Practise Law or Provide Legal Services:

Signature of Witness:

Print Name of Witness:

Page 8 AUTHORIZATION AND DIRECTION TO INSURANCE PROVIDER TO RELEASE INFORMATION

I, , of hereby authorize and direct my professional liability insurance provider, , to provide full disclosure to the Law Society of Ontario with respect to claim file information and deductible details.

This authorization is valid only for the purpose of processing an application under rule 7.6-1.1 or subrule 6.01(6) to the Law Society of Ontario to retain, occupy office space with, use the services of, partner or associate with, or employ in any capacity having to do with the practice of law or provision of legal services any person who, in Ontario or elsewhere, has been disbarred and struck off the Rolls, has had their licence to practise law or to provide legal services revoked, has been suspended, has had their licence to practise law or to provide legal services suspended, has undertaken not to practise law or to provide legal services, or who has been involved in disciplinary action and been permitted to resign or to surrender their licence to practise law or to provide legal services, and has not had their licence restored.

Date:

Signature of Former or Suspended Licensee or Licensee who has Given an Undertaking not to Practise Law or Provide Legal Services:

Signature of Witness:

Print Name of Witness:

If you had multiple insurers, photocopy pages 9 and 10 and complete an Authorization and Declaration (page 9) and Insurance information form (page 10) for each insurer and attach to your application.

Page 9 INSURANCE INFORMATION FORM (if other than LAWPRO):

Policy Number:

Start Date:

End Date:

INSURER INFORMATION:

Name of Insurer:

Address:

Telephone:

Fax:

Email:

BROKER INFORMATION:

Name of Broker:

Address:

Telephone:

Fax:

Email:

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